The present invention relates to an ultrasonic coagulating/cutting apparatus for carrying out treatment such as incision, excision, or coagulation of an organism tissue by utilizing ultrasonic waves while grasping the organism tissue in- and outside the body.
An apparatus described in U.S. Pat. No. 5,322,055 is generally known as an example of an ultrasonic coagulating/cutting apparatus. This ultrasonic coagulating/cutting apparatus is provided with an ultrasonic vibrator for generating ultrasonic vibration, a vibration transmitting member connected to the ultrasonic vibrator, a blade (probe) formed on the distal end portion of the vibration transmitting member, a jaw supported opposite to the blade for open-close motion, and a handle section for opening and closing the jaw.
In use, the jaw is opened or closed with respect to the blade through handle operation on the handle section. As the jaw is closed or rocked toward the blade, an organism tissue is held between the jaw and the blade.
Further, the ultrasonic vibrator is actuated with the organism tissue grasped. Ultrasonic vibration from the ultrasonic vibrator is transmitted to the blade by means of the vibration transmitting member, and the organism tissue is coagulated with the frictional heat of the ultrasonic vibration generated in the region of contact with the organism tissue as the organism tissue is subjected to treatment such as incision. As this is done, coagulating action and cutting action simultaneously work on the grasped region of the organism tissue, and the grasped part of the organism tissue region is cut without entailing bleeding.
Described in U.S. Pat. No. 5,322,055, moreover, is an arrangement such that the blade is provided with a knife-shaped cutting portion and a coagulating face having a profile substantially in the shape of a circular arc, and a state in which the cutting portion of the blade is opposed to the jaw and a state in which the coagulating face is opposed can be switched to and from each other. In the case where the cutting portion of the blade is opposed to the jaw, the cutting action for the grasped region of the organism tissue can be enhanced. In the case where the coagulating face of the blade is opposed to the jaw, moreover, the coagulating action for the grasped region of the organism tissue can be enhanced.
In the apparatus described in U.S. Pat. No. 5,322,055, however, the blade is provided with the cutting portion and the coagulating face, so that the construction of the blade is inevitably complicated. Further, the set state of the blade with respect to the jaw is changed to switch the mode between the state in which the cutting portion of the blade is opposed to the jaw so that the cutting action for the organism tissue is enhanced and the state in which the coagulating face of the blade is opposed to the jaw so that the coagulating action for the organism tissue is enhanced. Thus, blade changing operation for ultrasonic treatment is troublesome.
Described in Jpn. Pat. Appln. KOKAI Publication No. 8-275951, moreover, is an apparatus of a similar arrangement such that a jaw is activated by handle operation to hold an organism tissue between itself and a blade, and ultrasonic vibration is applied to the jaw to subject a grasped region of the organism tissue to treatment such as incision, excision, or coagulation.
Also described in this publication, furthermore, is an arrangement such that the jaw is provided with a coagulating face with a wide area of contact with the organism tissue and a cutting portion with a narrow area of contact with the organism tissue, and a state in which the cutting portion of the jaw is opposed to the blade and a state in which the coagulating face is opposed can be switched to and from each other. In this case, the cutting action for the grasped region of the organism tissue is enhanced when the cutting portion of the jaw is opposed to the jaw, and the coagulating action for the grasped region of the organism tissue is enhanced when the coagulating face of the jaw is opposed.
In the apparatus described in Jpn. Pat. Appln. KOKAI Publication No. 8-275951, however, the jaw is provided with the coagulating face and the cutting portion, so that the construction of the jaw is inevitably complicated. Further, the set state of the jaw is changed to switch the mode between the state in which the cutting action for the organism tissue is enhanced and the state in which the coagulating action for the organism tissue is enhanced. Thus, jaw changing operation for ultrasonic treatment is troublesome.
If the handle section is moved to its fully-closed position as the organism tissue is subjected to ultrasonic incision, in the apparatus of the conventional arrangement described above, moreover, the jaw is moved to its fully-closed position, whereby the grasped region of the organism tissue can be cut. As this is done, in the apparatus of the conventional arrangement, a constant grip force is generated when the handle section is moved to its fully-closed position so that the organism tissue is held between the blade and the jaw. Thus, it is hard to obtain appropriate coagulating/cutting performance according to the kind and thickness of the organism tissue.
In subjecting the organism tissue to treatment such as hemostasis, furthermore, the grasped region of the organism tissue can be subjected only to treatment such as coagulation without being cut if the jaw is held in a halfway position reached before it is moved to its fully-closed position with respect to the blade, that is, a halfway position reached before the handle section is moved to is fully-closed position, for a suitable period of time. The operations to hold the handle section in the halfway position reached before it is moved to the fully-closed position for the suitable period of time and to coagulate the organism tissue are carried out depending on an operator""s feeling of operation.
However, the operating force for the handle section is subject to variations between individual operators, and continual operation with stable handle operating force requires experience and skill, so that variation in the finish of treatment is substantial. If the handle section is held with a small operating force for a relatively long time, for example, the range of coagulation for the organism tissue is wide. If the treatment for coagulation is finished with a great operating force for the handle section in a relatively short time, the range of coagulation for the organism tissue is narrow.
In subjecting the organism tissue to coagulative incision, moreover, there is a possibility of the organism tissue being mechanically cut before it is coagulated with the frictional heat of ultrasonic vibration in an extreme case if the handle is operated extraordinarily strongly or if the organism tissue is nipped with a great force, for example.
The present invention has been contrived in consideration of these circumstances, and its object is to provide an ultrasonic coagulating/cutting apparatus of simple construction, capable of obtaining appropriate coagulating/cutting performance according to the kind and thickness of an organism tissue, and designed so that operation for the coagulation or coagulative incision of the organism tissue requires no special experience or skill, and which also enables a stable handling operation to be carried out with little possibility of entailing variation in the finish of treatment.
Another object of the present invention is to provide an ultrasonic coagulating/cutting apparatus of simple construction, capable of efficiently coagulating and excising an organism tissue at the same time.
In order to achieve the above objects, the present invention is provided with a switching member for switching the force to hold an organism tissue between a jaw and a probe during operation for opening or closing the jaw.
According to the present invention, moreover, the force to hold the organism tissue between the jaw and the probe during the operation for opening or closing the jaw is switched and adjusted by means of the switching member. Thus, appropriate coagulating/cutting performance can be obtained according to the kind and thickness of the organism tissue.
Further, the present invention in another aspect is provided with a position switching member accessible to external operation and capable of switching the moved position of the jaw being closed between a cutting position for cutting the organism tissue held between the jaw and the probe and a coagulating position where the jaw is stopped at a halfway position short of the cutting position.
According to the present invention, moreover, the moved position of the jaw being closed is switched by means of the position switching member between the cutting position for cutting the organism tissue held between the jaw and the probe and the coagulating position where the jaw is stopped at the halfway position short of the cutting position. Thus, appropriate coagulating/cutting performance can be obtained according to the kind and thickness of the organism tissue, the operation for the coagulation or coagulative incision of the organism tissue requires no special experiences or skill, and moreover, stable handle operation can be carried out with little possibility of entailing variation in the finish of treatment.
Further, the present invention in another aspect is provided with a non-contact portion located at least at a part of that surface of one member, the jaw or the probe, which faces the other member and capable of coagulating a to-be-treated region held between the probe and the jaw when the jaw is closed or rocked toward the probe.
According to the present invention, moreover, the to-be-treated region held between the probe and the jaw is excised (or incised) by means of contact portions of the jaw and the probe and the to-be-treated region held between the probe and the jaw is coagulated by means of the respective non-contact portions of the jaw and the probe when the jaw is closed or rocked toward the probe, whereby the coagulation of the organism tissue and the excision of the organism tissue can be carried out efficiently at the same time.
Further, the present invention in another aspect is provided with a projection located on the extreme end portion of the probe and serving to nip the organism tissue in conjunction with the jaw opposite thereto.
According to the present invention, moreover, the to-be-treated region held between the probe and the jaw is excised (or incised) by means of projections on the respective contact portions of the jaw and the probe and the to-be-treated region held between the probe and the jaw is coagulated by means of non-contact portions of the jaw and the probe other than the projections when the jaw is closed or rocked toward the probe, whereby the coagulation of the organism tissue and the excision of the organism tissue can be carried out efficiently at the same time.
Additional objects and advantages of the invention will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The objects and advantages of the invention may be realized and obtained by means of the instrumentalities and combinations particularly pointed out hereinafter.